The politics of public health: A rapid review of the impact of public health reform on population health outcomes

Abstract

Canada’s public health (PH) systems are vulnerable to constant system and structural changes, influenced by political and economic factors. This rapid review examines how PH system restructuring impacts population health outcomes, with special consideration of health equity. Due to a lack of Canadian evidence, international research was examined to produce recommendations for Canadian nurses, researchers, and decision-makers. Evidence indicates that PH spending and PH system organization have important impacts on population health outcomes and suggests PH reform has a negative impact on health equity. Opportunities for advocacy, activism, lobbying and capacity building to achieve health equity are discussed. Nurses, in a unique position between public policy and the lives of those they care for, are presented with the opportunity to effect social change through political action and to work across disciplines to address inequities. We encourage researchers and decision-makers to prioritize looking more deeply at the impact of PH reform.